title: Emergency department physician telemedical triage.
abstract: BACKGROUND
  Telemedical physician triage (TPT) is a potential application of telemedicine in the emergency department (ED). We report the technical success, patient satisfaction, and effect on ED throughput metrics (length of stay [LOS] and time to physician evaluation [TPE]) of TPT performed on a mobile platform.
  
  
  METHODS
  Patients underwent standard nursing triage with or without TPT. Technical success is reported as raw data. Patient satisfaction is reported as raw data±standard deviation on a 5-point (low-to-high) scale. LOS and TPE are reported as mean±SD [95% CI] values. Statistical analyses of LOS and TPE are via two-sample t test.
  
  
  RESULTS
  One hundred six patients were registered during intervention periods, and TPT was completed in 36 (34%). One hundred ninety-six patients were registered during control periods. The technical success rate was 95%. Average patient satisfaction was 4.7 on a 5-point scale. The primary analysis (106 patients) showed no change in LOS (266±101 [244-288] min versus 258±172 [234-282] min) but a trend toward improved TPE with TPT (35±28 [29-41] min versus 42±31 [38-46] min) (p=0.052). A secondary analysis (36 patients) showed no change in LOS (273±125 [231-316] min versus 258±172 [234-282] min) but improved TPE with TPT (16±15 [11-21] min versus 42±31 [38-46] min) (p<0.0001).
  
  
  CONCLUSIONS
  TPT in the ED on a mobile platform was technically successful, well accepted by patients, and associated with a decrease in TPE but not LOS.
authors.affiliation: 1 Department of Emergency Medicine, Mayo Clinic Arizona , Phoenix, Arizona.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Traub
authors.forename: Rebecca
authors.initials: R
authors.lastname: Butler
authors.forename: Yu-Hui
authors.initials: YH
authors.lastname: Chang
authors.forename: Christopher
authors.initials: C
authors.lastname: Lipinski
mesh_terms: D004635:Emergency Medicine / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010865:Pilot Projects; D012189:Retrospective Studies; D017216:Telemedicine / Q000458:organization & administration*; D013997:Time Factors; D014218:Triage / Q000379:methods*